Hand hygiene and skin health

Hand hygiene is the most important and effective procedure for the prevention and control of infections.

In caring for sick people, the hands constitute a vehicle for the transmission of pathogens, either through direct contact from person to person, or indirectly through previously contaminated objects, which can subsequently contaminate the patient.

Hand hygiene is a very simple action, and should be practiced by every person who takes care of a patient, whether they are healthcare personnel or caregivers.

Despite being the most important measure to reduce the incidence of infection and the spread of microorganisms, compliance with hand hygiene standards is very low.

It is a structure that constitutes a protective barrier between the external environment and the organism preventing the passage of germs into it.

The normal flora of the skin can be:

Transient flora: Consists of microorganisms that colonize the superficial layer of skin to which they adhere after contact with contaminated patients or surfaces.
Resident flora: Made up of microorganisms that survive and multiply in the deeper layers of the skin, and although they are less related to infections, they are more difficult to eliminate with a hand wash.
Water and soap, in general, are sufficient to eliminate transient flora. However, to eliminate the permanent flora, necessary in the case of wound management and in the care of patients in certain cases, the use of antiseptics in handwashing is necessary.

Reduce hand contamination and prevent the spread of pathogenic germs to uncontaminated areas.
Prevent the transmission of infections in the health environment.
Protect the patient, healthcare staff and caregivers.

Health personnel who maintain direct and indirect contact with the patient.
Caregivers who maintain direct and indirect contact with the patient.
Anyone who works in a health center.

General indications for hand washing and antisepsis:


Start the workday at the health center.
Touch any patient (especially in direct contact with patients susceptible to infections) to protect them from the pathogenic germs that we carry in our hands.


Perform invasive procedures or any task that requires asepsis, even if gloves are used, such as placing permanent urinary catheters, peripheral catheters or other devices.
The preparation of food or medication.


Exposure of the hands to blood or other body fluids, to mucous membranes, to non-intact skin and wound dressings, or after touching potentially contaminated objects or objects located in the immediate vicinity of the patient, when touching material contaminated with secretions, even if the hands Be apparently clean.
Having contact with the intact skin of a patient (eg when taking the pulse or blood pressure, lifting the patient, etc.) or their surroundings.

Come back from the dining room.

Use the services

End the workday in a health center.

Before and after:

Maintain contact with wounds of all kinds.
Manipulate drainage systems.
Wear gloves.

Contacts maintained with different patients (especially in high-risk units).
Handling of a contaminated area to a clean area of ​​the patient’s body during care.
Hand washing is recommended in all cases in which doubts arise between the need or not to perform it.

Selection of hand washing products:

The choice of a washing agent will depend on the degree of contamination, the need to reduce the resident and transient flora to a greater or lesser extent, and the susceptibility of each patient.

Hand hygiene products must be effective and have a low potential for irritation, especially when used frequently. The sensation, smell and skin tolerance of the products must be assessed in the choice.

Containers containing washing agents should not be filled when they are half empty, since the product can be contaminated with bacteria. It is preferable that they have a dosing mechanism, this should always be kept clean.

In the case of using antiseptic products, it must be known that there may be incompatibility between them, or with the soaps and with the type of gloves to be used, so the correct choice must be checked.

Among the most used products we have:

It should preferably be liquid and with neutral pH, in a single-use container and with a dispensing valve. Basically it is a cleaning agent. Although its antimicrobial activity is minimal, its primary mechanism of action.